Talk:Spike-and-wave

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CorenSearchBot found some repeats of this text with the scholarpedia spike-and-wave oscillation, and the text has been reworded to remove this resemblance. Reference to this article has been given.

Y Accepted tentatively as fixed. Next time, please recreate the article in your own words with the information you gleaned from the reference, without any language from the original. Minor rewording is generally not sufficient. — madman bum and angel 19:22, 19 January 2008 (UTC)

This page will be a work in progress for a class that’s running through the end of the semester. Project description here. -Mjavorski (talk) 01:51, 31 October 2012 (UTC)

Review

Good work so far! I have a few suggestions and some questions for revision. The “Pathophysiology” section seems somewhat contradictory to me. In particular, the sentence: “Although there is evidence for the generation of a large EPSP, many studies have shown that synaptic inhibition remains unhindered in these types of paroxysmal depolarizing shifts, and also that a decrease in the inhibitory activity does not affect the synaptic strength which can facilitate the recruitment of more neurons in the cortex” is contradictory – if synaptic inhibition is not affected in paroxysmal depolarizing shifts, why has it been noted that a decrease in the inhibitory activity does not affect synaptic strength? Also, what do you mean by “recruitment of more neurons in the cortex”? And later on in the paragraph it is mentioned: “Many studies have shown that the inhibitory postsynaptic signaling is actually increased during these epileptic attacks.” This seems contradictory to the first sentence of the paragraph. Don’t forget to cite these studies and to include references in this section! To make the “Pathophysiology” section flow more smoothly, I think you could remove some of the definitive articles. Finally, I think you should consider the pertinence of the “Clinical Relevance” section. Do these AEDs treat seizures characterized by spike-and-wave? -Reedich (talk) 16:47, 29 November 2012 (UTC)

• Thanks for the comment, I made some edits to help eliminate some of the confusion in the pathophysiology section. I also added another reference to support the statement that the inhibitory signaling can actually be increased during an epileptic attack. I also added "spike and wave discharges" to the clincal relevance section to show that the AEDs do treat seizures characterized by SWDs. Mjavorski (talk) 04:02, 30 November 2012 (UTC)

Peer Review

This is article is very well written and is structured properly. All of the information is presented and explained in a clear and concise manner, and I found the topic to be very interesting. There were very few grammatical errors, but I would still recommend proofreading the entire article. The one major error that I found was in the last sentence of the absence epilepsy section. I think the sentence structure just needs to be adjusted to make sense. Most of the key ideas about spike-and-wave and its occurrence in various epileptic conditions are presented in the article, but there is one content issue that I would like to address.

One topic that I think could be expanded on is the mechanistic cause of the spike-and-wave. Under the pathophysiology section, you discuss the role of EPSPs and IPSPs in the spike-and-wave pattern, and you go into some detail about the specific receptors (GABAa) that are involved with the IPSP. I think that you also need to go into a little more detail about the EPSP aspect of the spike-and-wave. I found an article, Ngomba et al (PMID: 21569017), which discusses the role of metabotropic glutamate receptors in the development of the spike-and-wave. I think this would help just to clarify a little further the underlying mechanism of this pattern. This paper also talks about these receptors as potential drug targets, which may be an interesting point to add to the clinical relevance section.

Mlodzins (talk) 21:56, 16 November 2012 (UTC)

• Thank you for your feedback. We fixed the last sentence of absence epilepsy section and corrected some grammatical errors. The paper that you suggested was very helpful, and I added another paragraph to the pathophysiology section to explain its role in spike and wave discharges. I also added some info about using mGlu4-R antagonists as a potential new drug, however I kept it in the pathophysio section since these drugs are still being developed. Mjavorski (talk) 22:22, 2 December 2012 (UTC)

In general, this article was easy to follow, extremely well-written, and includes a plethora of significant research and information. There were several grammatical errors that I picked up on including: Intro- “anti-eptileptice drugs” should say “anti-epileptic drugs” (also I would suggest rewording the last sentence of the intro so that it says there are several theories AND research has been done to provide new insight); Research on Environmental Factors- “absences seizures” should say “absence seizures”; Pathophysiology: parentheses around second and third PDS are unnecessary (also link to PDS Wikipedia page); Absence epilepsy- second to last sentence is incomplete; Ohtahara syndrome: “mamilary bodies” to “mammillary bodies”, “pssychomotor” to “psychomotor”. I would also recommend linking to the Wikipedia pages of each type of epilepsy in the Spike-and-wave in Epilepsy section.

I like the picture of the EEG. It would also be helpful to have a diagram of the brain structures involved in spike-and-wave so the reader can better visualize the process. For the History section, is the first diagnosed case and coining of the term “spike-and-wave” documented? That would be a relative addition to the page to understand how long this particular mechanism has been recognized, and also so that the reader can have a better understanding of epilepsy as a disease.

The Pathophysiology section does a wonderful job of explaining what the “spike-and-wave” consists of physiologically and how it is represented in an electroencephalogram. Also the description of the differences between the spike and wave phases was effective and allows the reader to distinguish between the two phases. Separating different seizure disorders and talking about how spike-and-wave figures in each was also organized and written well in addition to being informative.

Carrolni (talk) 23:31, 19 November 2012 (UTC)

• Thank you for your nice comments. I went over the grammatical errors, made those changes, and proofread the article. I added a picture that separates the major areas of the brain to make the pathophysiology section easier to visualize. Again, thank you for the helpful comments!! BlakePierce (talk) 18:52, 2 December 2012 (UTC)

Appreciate the proof read for grammar. I fixed the last sentence to the absence seizure section by dividing it up into two sentences to make it flow a little better as well. Also, fixed the grammar errors located in the "Research on Environmental Factors" section. Thank you for your review. Tyler7810 (talk) 20:58, 7 December 2012 (UTC)

Peer Review

Overall, the article is well researched, and for the most part, grammar and sentence structure are good, but there are a few phrasing issues as well as inappropriate capitalization. I also noticed a couple inconsistencies in the use of “spike and wave” instead of “spike-and-wave” (in epilepsy section). In general, the order and manner in which the information is presented makes sense; sentences are concise and to the point and (with the exception of a few awkwardly worded sentences) easy to understand.

In the overview, consider linking to the cerebral cortex page. I would also suggest removing the following sentence: “One proposal suggests that a thalamocortical (TC) loop is involved in the initiation spike-and-wave oscillations.” Try to keep the overview as general as possible. Because of Wikipedia’s concerns in remaining free of bias, it would be best to not single out any one area of research, as this could be considered as favoring or biased. The overview gives a very good idea of what spike-and-wave is, and it is particularly effective because it is concise and direct.

I found the history section to be interesting and am wondering if you have any information on who Gibbs, Davis, Lennox, and Pollen were. Since they don’t have their own Wikipedia pages it may be worth it to include a couple words about where they did their research or were affiliated, if you have that information. It would be interesting for the reader and also give the reader the necessary information to research the topic further.

In the pathophysiology section, the word “viewpoint” stood out to me. Since Wikipedia strives to be unbiased, “viewpoint” may not be the best word choice; it could confuse the reader as to whether or not the described mechanism of the PDS was an opinion or a theory supported by evidence. Something to the effect of “The initial understanding of the PDS was…” would be more impartial. In that same sentence, PDS appears in parentheses. I think this was probably accidental; the parentheses should be removed. Also under pathophysiology, the subheadings “Research on Initiation Factors” and “Research on Environmental Factors” include unnecessary capitalization. “Research on initiation factors” and “Research on environmental factors” would better fit Wikipedia guidelines for a Good article.

I have spent a lot of time trying to figure out if those two research subheadings make sense in the pathophysiology section, or if they would be better as a separate research section later in the article. According to Wikipedia, pathophysiology is “the study of the changes of normal mechanical, physiological, and biochemical functions, either caused by a disease, or resulting from an abnormal syndrome. More formally, it is the branch of medicine which deals with any disturbances of body functions, caused by disease or prodromal symptoms.” I think the information in these two subheadings is important to the pathophysiology section, so I would suggest emphasizing how this research has implications on the study of spike-and-wave specifically related to disease. This concluding sentence was effective: “This model concludes that low glucose levels could be a potential trigger for absences seizures, and could be an environmental risk factor for humans.” Something similar for the other two paragraphs, relating the research back to disease and spike-and-wave, would be beneficial and emphasize why this information belongs under pathophysiology.

In the spike-and-wave in epilepsy section, I don’t think that “Onset” at the end of the first paragraph should be capitalized. Also, in regards to the section on OS, a Google search showed that “early infantile epileptic encephalopathy” and “suppression-burst” do not need to be capitalized. The list used in this section was effective and is organized and easy for the reader to understand. Additionally, the capitalization of the “Spike-and-Wave Pattern during Sleep” and “Clinical Relevance” subheadings should be changed such that only the first word is capitalized.

In the spike-and-wave pattern during sleep section, there is also a fragmented sentence that needs to be addressed: “In a rare form of age-related epilepsy, where children between the ages of three and seven exhibit continuous spike-and-wave discharges during slow-sleep (CSWS).” An alternative may be: In a rare form of age-related epilepsy, children between the ages of three and seven exhibit continuous spike-and-wave discharges during slow-sleep. I am not sure what CSWS is referring to here; if this is the name of that type of epilepsy, a better sentence may be: In CSWS, a rare form of age-related epilepsy, children between the ages of three and seven exhibit continuous spike-and-wave discharges during slow-sleep. If you know what CSWS stands for, you should include that information as well.

In the clinical relevance section, spike-and-wave is not mentioned once. Can you relate this information directly to spike-and-wave? Even just a couple sentences relating the information directly to spike-and-wave would make a big difference in the relevance of this section to the entire article. Based on the abstracts of the two sources cited in this section (Guerrini; Perucca), the sources appear to be focused on epilepsy and anti-epileptic drugs. You may need to find additional sources to relate anti-epileptic drugs directly to spike-and-wave. It would probably be sufficient to include just how the drugs cause the spike-and-wave to change. I would also propose a change to the following sentence to remove the personal pronoun: “Bromide was introduced as the first anti-epileptic drug 150 years ago. The adverse effects mentioned above are one of the reasons we don’t use bromide much today.” The new sentence could be something similar to the following: Bromide was introduced as the first anti-epileptic drug 150 years ago. Because of the adverse effects mentioned above, bromide is not currently in use as an anti-epileptic drug.

Kmcglynn (talk) 02:12, 20 November 2012 (UTC)

Thank you for your comments! I appreciate the time and effort you put in for this detailed review.

• I went through and corrected the “spike-and-wave” inconsistencies. Cerebral cortex is now linked in the intro.
• I have decided to keep the intro sentence regarding the TC proposal. The research is good and the topic is a very important part of our article. Also, we do not favor/show bias by including the article in our introduction. We simply state that a proposal suggests the TC loop is involved in the initiation of spike-and-wave oscillations.
• Thank you for the nice words on the history section, we are not able to find more information on the individuals and do not want to stray from the topic-subject.
• I made changes to the wording of the pathophysiology section to make it less biased. I also fixed the capitalization errors in the subheadings. I have gone through those two sections to make sure that there is something that relates the research being done back to the disease.
• I fixed the capitalization errors in the OS and the subheadings below. I also revised the introduction sentence for spike-and-wave pattern during sleep so that it makes more sense and is easier to read.
• The last section now mentions spike-and-wave discharges.

BlakePierce (talk) 21:54, 2 December 2012 (UTC)

This article is very well written with a large amount of information in each of the different sections. Throughout the article as a whole, I find immense amounts of information both illuminating and detailed, but sometimes it manifests itself as a disadvantage. I believe that some clarification or simplification could be helpful in the Pathophysiology section, and the section titled Research on Initiation Factors. Both of the paragraphs are extremely detailed and may throw off some people who are not very familiar with the information. A breakdown of the information might also help. Both of the afore mentioned subjects are very long with few breaks and partitioning the information might help guide the reader a bit more.

Once or twice throughout the paper, the phrase “several studies have shown” or slight variations of this were used when only one reference was sited. If you could clarify which other studies have researched the same material, this may help someone in need of more information regarding that certain topic. Lastly, the Clinical Relevance section might also stand to gain from rearranging the flow of the paragraph a little. If several of the sentences mentioning bromide and other past drugs was moved to the beginning of the paragraph, this might help to give more chronological order. najabouarraj (talk) 23:45, 19 November (UTC)

• Thanks for the comment. In order to clarify the pathophysiology and clinical relevance sections, I added some more links so that the terminology can be looked up easily. Each paragraph has a specific aim, so I will leave them as they are. I added several more citations to those places where I say "many studies have shown", which was a very good idea...thanks. I also reorganized the clinical relevance section so that it flows better and has some chronology. Mjavorski (talk) 01:37, 3 December 2012 (UTC)

• Again, thank you for your thorough review. I researched CSWS to make sure it didn't have any other titles and this seems to be the one most used. Also, i switched the heading of the environmental factors heading and added another source as well to relate it back to the article a little more Tyler7810 (talk) 20:59, 7 December 2012 (UTC)